Time for a ‘Manhattan Project’ Against Epidemic Disease
Fareed Zakaria, interviewing medical expert Dr. Sanjay Gupta on CNN on March 1, remarked that our response to the coronavirus seems to be little different from measures taken to combat plagues of the Middle Ages: quarantine and cleanliness.
He could also have noted that similar to panic reactions to the plagues of the Middle Ages — despite all our great scientific advances — the world population today feels as vulnerable and helpless, with no sure method of escaping contagion.
Dr. Gupta didn’t dispute Zakaria’s observation, but added: “We have better answers today but they take time — time to develop effective treatments and vaccines.”
So the challenge is how to cut the time.
When posed that way, our answer to potential pandemics has been inefficient if not plain dumb, considering their extreme threat to life and world economies.
Each time there is a new dangerous virus outbreak, we often default to the market model of asking individual biotech companies to compete for a solution. Not only is this a fragmented approach, but precious time is lost while they gear up to the task.
President Donald Trump initially speculated that the arrival of warm weather would distill the coronavirus threat. However, his more proactive plan invoked the knee-jerk business-as-usual “leave it to the market” model. That’s why he called a meeting at the White House on March 2 (two months after the world learned of the outbreak in Wuhan, China) of the leading biotech companies. Some believe we can produce good results when these private companies compete with each other to address the crisis.
But there’s a hitch. Not all companies will jump in. Some are already backing off. The sticker price for research and development is scaring them. They fear if they don’t win the race to the vaccine, their losses will adversely affect company earnings and drive down the share prices of their stocks.
So competition that looks appealing at first blush may have serious flaws that compromise public health. And companies that don’t participate in the competition may be eliminating talented scientists from the quest for effective treatments and a vaccine.
The success of the Manhattan Project in developing the atomic bomb offers a compelling reason why “leave it to the market” is not in the best public health interest for addressing potential pandemics.
In 1939, not too much was known about atomic fission. But Albert Einstein’s work indicating that splitting the atom could unleash unimaginable destructive power prompted the scientist to warn President Franklin Roosevelt that Germany was possibly working on an atomic bomb. Perhaps because it sounded like science fiction, it wasn’t until 1942, when the US was well into World War II, that FDR fully acted on that warning, fearing that Germany might get a bomb first and win the war.
To develop the bomb, FDR didn’t call a meeting of representatives of tech companies with the prompt: “Compete: there are big bucks for the winner.” Instead, he established the Manhattan Project, located mainly in Los Alamos, New Mexico, where the greatest scientists from around the world were assembled. They achieved their goal in a few years at a cost of $2 billion ($24 billion in today’s dollars) — an amount or more that will be spent on defensive measures in response to the coronavirus, not a cure or future protection.
Today, we arguably know much more about viruses and their related biology and chemistry than the Los Alamos scientists knew about atomic fission.
Why then don’t we establish a similar Manhattan Project — this time to protect and save lives? Call it the Pandemic Strike Force — designed to respond promptly to pandemic threats by conscripting the best scientists in the world to work on solutions collectively rather than in secret at their private companies. Such a project would not require an extensive physical location like Los Alamos. A relatively small central laboratory might do, along with the deployment of virtual laboratories with collaboration through video conferencing.
Dr. Amira A. Roess, professor of Global Health and Epidemiology at George Mason University, agrees that a permanent structure with advanced scientific capability could accelerate responses to pandemic threats. More importantly, she added in a telephone interview on March 6, such a resource would also enable vital research after viruses fade.
“Typically,” she said, “when the threat goes away the funding goes away.” And biotech companies, she noted, often drop research on viruses after they are contained or fade, despite the fact that they could return in even more virulent forms. She regrets that our current system is about “reacting not prevention.” This, she says, leaves unanswered fundamental questions, like what enables viruses to emerge and spread. And just as biotech companies make decisions about what to research based on economics, “great minds,” she laments, “have to make hard decisions about what research questions are fundable.”
Let’s finally acknowledge that the Middle Ages are over and take action that capitalizes on 21st-century technologies.
At an online Zoom press briefing on March 16, hosted by Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), immunologist Dr. Maria Van Kerkhove reported that 300 clinical trials are underway worldwide to find effective treatments and a vaccine for coronavirus — some by private companies, others by government entities. While this is encouraging news, there is a downside to so many companies and entities working independently. Undoubtedly, many of these pursuits are on similar or related paths at different stages of development with some shifting directions after failures or indications of dead ends. Wouldn’t it be far more productive if these clinical trials were under a unified and more joint command, with daily sharing of findings?
In battling recent pandemic scares in outbreaks of the SARS, Ebola, and Zika viruses, we dodged lethal bullets and worst-case scenarios by bringing these devastating viruses under control, or just got lucky when they miraculously faded — at least for the moment. But are we willing to gamble on luck when the stakes are deadly pandemics that could kill much of the world population?
Yet whenever I suggest to political pundits and healthcare professionals the need for a permanent Pandemic Strike Force modeled after the Manhattan Project, the response is always the same: “We can’t afford the billions. It will never happen.”
An estimate by Bloomberg Economics that the coronavirus could cost the world economy as much as $2.7 trillion should be a sobering wake-up call that we can’t afford not to have a Manhattan Project for pandemics. Otherwise, we will continue to bet on the marriage of pandemics and the market model — a marriage “until death do us part.”
Bernard Starr, PhD is Professor Emeritus CUNY, Brooklyn College. For several years he wrote on healthcare and issues of an aging society for the Scripps Howard News Service. For seven years he was producer, writer, and host of the award winning Longevity Report on WEVD AM radio in New York City.